Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

B&J Final > Gout and Hyperuricemia > Flashcards

Gout and Hyperuricemia Flashcards

1
Q

Gout is

A

Hyperuricemia + recurrent attacks of acute arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define hyperuricemia

A

Serum uric acid >7 in men and >6 in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute arthritis caused by

A

Deposition of monosodium urate crystals in joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Gout leads to

A

Pain, joint destruction and loss of function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define Uric Acid nephrolithiasis

A

Kidney stones of uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define Tophi

A

Depositis of monosodium urate crystals in soft tissues of the body -> joint destruction and nerve compression and deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Gout Epidemiology

A

Males
Increases with age
Incidence in women after menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Serum urate concentration correlates with

A 
Males
Age
Body weight obesity
Renal insufficiency
Alcohol intake
Genetics
Lead exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Xanthine oxidase

A

Reduces hypothanthine to xanthine to uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Urate is the

A

predominate species of uric acid in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hyperuricemia causes

A

Diet
Overproduced by increased breakdown of nucleic acids (cancer)
Increased cytotoxic drugs
Genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Genetics

A 
Overactivity of PRPP synthetase (purine accumulation)
HGPRT deficiency (accumulation of PRPP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PRPP Synthetase

A

Superactive PRPP leads to excessive purine

Five genetic mutations associated with superactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HGPRT deficiency

A

Involved in purine salvage pathway

Usually takes purines and makes monophosphates but deficiency = more to uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other causes of Hyperuricemia

A

Underexcretion

Renal elimination/reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Joint Response to Urate

A

Local vasodilation, pain, heat, edema, inflammation, tissue damage via IL-1beta

17
Q

Acute Gouty Arthritis

A

Sudden onset of sharp/intense pain, erythema, swelling

First attack is usually monoarticular and usually the big toe

18
Q

When do acute attacks usually occur?

A

During the night bc water reabsorption from joint space

19
Q

Uric Acid Nephrolithiasis

A

Uric acid kidney stones

Excessive urinary excretion

20
Q

Gouty Nephropathy

A

Acute leads to acute renal failure

Chronic: protein in the urine

21
Q

Tophaceous gout

A

SQ deposits –> late complication

Damage soft tissue and compress nerves

22
Q

Treatment of Gout

A

NSAIDS
Corticosteroids
Colchicine

23
Q

Prophylactic therapy

A 
Allopurinol
Febuxostat
Rasburicase
Pegloticase
Probencid
Sulfinpyrazone
24
Q

NSAIDs

A

Sulindac, Indomethacin, Naproxen
Relief from pain and inflammation
Consider coadmin of PPIs

25
Q

Corticosteroids Intraarticular

A

Limited to 1 or 2 joints

26
Q

Corticosteroids Systemic

A

Multiple joints

Risk of osteoporosis, HPA suppresion

27
Q

Colchicine MOA

A

Inhibits cell division and migration of neutrophils

Decreases their inflam activity

28
Q

Colchicine

Test question

A

Relieves acute gout attacks with low benefits to toxicity ratio

29
Q

Uric Acid Lowering Therapy

A

Block Uric acid formation
Enhance urate excretion
Enhance Urate elimination

30
Q

Enhance urate excretion drug

A

Uricosuric agents

31
Q

Block Uric acid formation

drugs

A

Allopurinol or Febuxostat

32
Q

Enhance Urate elimination drugs

A

Rasburicase

Pegloticase

33
Q

Allopurinol

A

Inhibitor of xanthine oxidase
Feedback inhibition of purine synthesis
NOT with azathioprine
SJS

34
Q

Febuxostat

A

Xanthine Oxidase inhibitor
Non-purine
CYP metabolism

35
Q

Rasburicase

A

Uricase
Uric acid to allatoin (more soluble)
Antibodies can form against the drug

36
Q

Pegloticase

Test question

A

Uricase
Increase excretion and immunogenicity against allatoin
No data on drug interactions

37
Q

Probenecid

A

OAT binds to uric acid so no reabsorption can occur

NOT with salicylates

38
Q

Sulfinpyrazone

A

Inhibits reabsorption
Longer acting and more potent then probenacid
Higher GI distress

B&J Final (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions